Individual
JASON JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 SPRING ST, WESTFIELD, WI 53964-9068
(608) 296-2139
Mailing address
161 SPRING ST, WESTFIELD, WI 53964-9068
(608) 296-2139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43701600
—
WI
Enumeration date
04/24/2008
Last updated
04/24/2008
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